The undersigned..............................................................................

                                                                      (the full name and PIN of the data subject)

 

 

DECLARE:

            I agree that "Fuudmedik" Ltd. with UIC 206324502 to process and store my personal data as required, in accordance with the provisions of the Personal Data Protection Act and in relation to Regulation (EU) 2016/679, which I provide in connection with receiving a specific service provided by "Fuudmedik" Ltd. with UIC 206324502, which I declare that I am previously familiar with.

             I know that:

             - my personal data, which I have provided to "Fuudmedik" Ltd. with UIC 206324502 within the framework of the aforementioned legal relationship, will be processed solely for the purposes of the services I receive.

             - I am informed that "Fuudmedik" Ltd. with UIC 206324502 may process my personal data only as long as and to the extent necessary in connection with the services provided by them. For processing outside these agreed parameters, "Fuudmedik" Ltd with UIC 206324502 needs my additional consent in accordance with the data protection regulations.

             - the information provided by me, as well as all personal data is stored in accordance with the Personal Data Protection Act, Regulation (EU) 2016/679 and the Privacy Policy of "Fuudmedik" Ltd with UIC 206324502;

I have been informed of my right to lodge a complaint with the supervisory authority in the event of unlawful processing of my personal data.

Date: ..................... Declarant: ........................